Beshear Increases Accessibility to Safe Anesthesia

Gov. Steve Beshear announced Friday that Kentucky has exercised its option to increase its citizens’ access to safe, high-quality anesthesia by giving more flexibility to providers in delivering anesthesia services. In a letter to the federal Centers for Medicare and Medicaid Services, Beshear said Kentucky is exempting certain facilities from a federal requirement that certified nurse anesthetists be supervised by a physician. This change will give many hospitals and ambulatory surgery centers greater flexibility in the use of anesthesia providers and improve operating room efficiency without affecting quality of care.

“We’ve consulted with the Cabinet for Health and Family Services and health care providers, and this is clearly a change we need to make to improve access to critical medical care,” Beshear said in a statement released by his office. “In cases like this, where the federal requirement is an obstacle to some of the best options for delivery of high-quality health care, we’re pleased to take this step to opt out.”

According to the Kentucky Association of Nurse Anesthetists, Kentucky is the 17th state to opt out in the 10 years since the federal government gave states this choice. A 2010 report in the journal Health Affairs offered an analysis of Medicare data for 1999–2005 which found no evidence that opting out of the oversight requirement resulted in increased inpatient deaths or complications.

“Certified registered nurse anesthetists are an extremely important part of health care delivery in Kentucky, particularly in the rural areas of the state,” Mike Rust, president of the Kentucky Hospital Association, said. “This opt-out will help ensure patient access to quality anesthesia care, and we thank the Governor for taking this important action.”

In the letter,Beshear noted that the decision is consistent with Kentucky law, and that “it is in the best interest of Kentucky’s citizens to opt out of the current federal physician supervision requirement in order to improve access to critical services.”

“The 700-plus members of the Kentucky Association of Nurse Anesthetists applaud Gov. Beshear and his staff for moving forward with a decision that is in the best interest of the state,” said Debbie Barber, the association’s president. “This decision will increase access to safe, cost-effective anesthesia care, particularly in rural and underserved areas of Kentucky.”